oral cancer power point presentation by dr amol dumbre

1. ORAL CANCER – A SILENT KILLER
Dr. Amol Dumbre Patil DNB
Consultant Oncosurgeon
Ruby Hall Clinic,Pune
KEM Hospital ,Pune

4. CANCER

10. CANCER

15. CANCER PREVENTION
 Healthy lifestyle
 Avoid tobacco: any form
 Alcohol
 Diet
 Exercise
 Mental stress
 Treatment of infections
 Screening

16. CANCER CURE
 Early diagnosis
 Prompt, aggressive and correct treatment
 No pain…….No gain
 Regular follow-up

17. FIRST CHANCE IS THE BEST CHANCE

18. EARLY DIAGNOSIS
 Screening
 Identify symptoms
 Seek expert help
 Good quality diagnostic tests
 Tumor markers, CT, MRI, PET Scan
 Good pathologist with good lab
 Immunohistochemistry (IHC)

19. SCREENING
 Finds cancer when asymptomatic
 Size very small, may not be palpable
 Cancer found is usually curable
 Simple tests
 Can be used in
 Breast cancer
 Cervical cancer
 Colon cacner
 Oral cancer
 Finds cancer early in persons who would otherwise surely get it later in
advanced, incurable stage.

25. SURGERY
CHEMOTHERAPYRADIOTHERAPY
TREATMENT

26. ORAL CANCER
 Magnitude of problem
 Prvention-primary and secondory
 Oral examination
 Premalignat lesions
 Cancerious lesions
 Treatment

27. INCIDENCE AND SURVIVAL
OF ORAL OR PHARYNGEAL CANCER
 30,000 new cases diagnosed yearly
 8,000 deaths each year
 5 year survival rate: 50%
USA

28.  New cases of cancers in India per year- about
7,00,000
 Tobacco related cancers - about 3,00,000
 Cancer of uteri - 1,00,000
 breast cancer – 80,000
(TMH-preventive oncology department)

29. ORAL CANCER
MORBIDITY & MORTALITY
 Most common cause of cancer death in most
parts of Asia
 5 year survival (20 -50 %)
 50,000 deaths in India annually. Primarily due to
late presentation (60-80%)
 Tata Memorial Hospital Of 2275 cases- Only 9%
in Stage I & II

30. BATTLE AGAINST ORAL CANCER !
 • Prevention
 • Improved treatment ( no significant change in
last 50 years)

31. ORAL CANCER – PREVENTION
 Primary Prevention
 Secondary Prevention – Early detection

32. PRIMARY PREVENTION
 Cancer prevention- Addressing the etiologic
agents
 Ban tobacco
 Behavioral modifications
 Educate the people

33. TOBACCO BAN – IMPLICATIONS
 India 3rd largest producer of tobacco
 900,000 employed in growing and curing
industry and 3.4 million in manufacturing 97.7
million dollar trade surplus
 Smokeless tobacco $ 1 billion annually = 0.2 %
of the gross national product
“only industry that has had a constant growth
for last few decades

34. SECONDARY PREVENTION
 Early detection of premalignant and malignant
lesions
Screening

35. EARLY DETECTION SAVES LIVES
 5-year survival for localized disease is 76%
 5-year survival for metastatic disease is 19%

36. EARLY DETECTION
 Increase survival
 Decreases morbidity
 Decreases cost of treatment

37. EARLY DETECTION IS OFTEN POSSIBLE
 Tissue changes in the mouth that may signal
cancer can often be seen and felt easily.

38. EXAMINATION OVERVIEW
 Head and neck exam should be a routine part of
dental and medical check-ups.
 Take a history of alcohol and tobacco use.
 Follow up on suspicious signs.

39. TOOLS AND TIME
 Proper lighting
 Dental mouth mirror
 Gauze squares
 Gloves
 5 minutes

40. EXTRAORAL EXAMINATION

41. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION: LIPS

42. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION: LABIAL MUCOSA

43. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION: LABIAL MUCOSA

44. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION: BUCCAL MUCOSA

45. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION: BUCCAL MUCOSA

46. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION: GINGIVA

47. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION: DORSUM OF
THE TONGUE

48. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION: LEFT MARGIN OF THE TONGUE

49. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION: RIGHT MARGIN OF THE TONGUE

50. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION: VENTRAL SURFACE OF THE
TONGUE

51. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION: HARD PALATE

52. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION: OROPHARYNX

53. PERIORAL AND INTRAORAL SOFT
TISSUE EXAMINATION

55. PREMALIGNAT CONDITIONS
Leukoplakia
Erythroplakia
Oral submucous fibrosis

56. PREMALIGNANT CONDITIONS-
LEUKOPLAKIA

57. ERYTHROPLAKIA

58. ORAL SUBMUCOUS FIBROSIS

59. MALIGNANT CONDITIONS

65. TREATMENT
 Surgery
 Radiation
 Chemotherapy

66. HEMIMANDIBULECTOMY

67. LIP WIDE EXCISION AND
RECONSTRUCTION

68. BUCCAL MUCOSA WIDE EXCISION

69. COMONDO OPERATION

77.  There is still much to be done. Oral cancer remains
a major health problem in India, and only dedicated,
sustained efforts towards early detection and
prevention will reduce the burden of this disease.

80. THANKS…

85. INTRODUCTION
 Oral Cancer is the sixth leading cause of cancer
worldwide
 The survival rate was 52%.
 Oral cancer generally are socially derived diseases.
 Tobacco and alcohol are synergistic effect
 Treatment of early oral cancer is surgery. Locally
advanced T3/4 are best treated with combined
surgery and Radiotherapy.
 High risk of second primary cancer. (Field
cancerization)

86. THE ABILITY TO CONTROL ORAL CANCER
WILL BE DEPEND ON:
PREVENTION
EARLY DIAGNOSIS
CONTINUING EDUCATIONAL CAMPAIGNS

87. "THERE ARE ABOUT 7,00,000 NEW CASES OF
CANCERS IN INDIA OUT OF WHICH TOBACCO
RELATED CANCERS ARE ABOUT 3,00,000, CANCER
OF UTERI ARE 1,00,000 AND 80,000 BREAST
CANCER. COST OF TREATMENT OF ORAL CANCER
IS ABOUT 3.5 LAKH. THIS CAN BE COMPLETELY
PREVENTED BY SIMPLE CHANGES IN LIFESTYLE AND
REGULAR SCREENING AND EVEN HAVE HEALTH
BENEFITS THAT REACH BEYOND CANCER. ABOUT
2000 DEATHS A DAY IN INDIA IS TOBACCO
RELATED."

88. Despite the fact that the oral cavity is
accessible for visual examination, and that
oral cancers and premalignant lesions
have well-defined clinical diagnostic
features, oral cancers are typically
detected in their advanced stages. In fact,
in India, 60-80% of patients present with
advanced disease as compared to 40% in
developed countries. Consistent with
patients presenting for medical care with
more advanced disease in India compared
with developed countries, overall survival is
also reduced. Early detection would not
only improve the cure rate, but it would
also lower the cost and morbidity
associated with treatment.

89. In this randomized, controlled trial of
almost 192,000 people, carried out over an
eight-year period, there was a significant
reduction in mortality in the intervention
arm (29.9 cases per 100,000) versus the
control arm (45.4 cases per 100,000), due
to detection of oral cancer at an early
stage.